Shaune Kelly Bornholdt PH.D.

NPI 1063673226 - Psychologist - 103T00000X

NPI Details
NPI 1063673226
Gender Female
Enumeration Date 06/20/2008
Last Updated 06/20/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
1165 MORRIS PARK AVE
BRONX NY, 10461-1915, US
Phone (718) 430-3900
Fax
Business Location
501 W 121ST ST
APT 52
NEW YORK NY, 10027-5903, US
Phone (212) 662-0137
Fax
Toxanomy
Taxonomy Code 103T00000X
License State New York
License Number 014867
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According to our database, Dr. Shaune Kelly Bornholdt PH.D. NPI is 1063673226, taxonomy code is 103T00000X and license number is 014867, license state is located at New York. Shaune Kelly Bornholdt PH.D. physically located at 1165 Morris Park Ave, Bronx NY, 10461-1915. NPI Number Shaune Kelly Bornholdt PH.D. has the Individual type.

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1063673226 NPI number is provided on an as is basis without warranty of any kind. 1063673226 is maintained by the National Plan & Provider Enumeration System. The contents of Shaune Kelly Bornholdt PH.D. are for informational purposes only.